Management of carotid artery rupture by monitored endovascular therapeutic occlusion (1988-1994)

Laryngoscope. 1995 Oct;105(10):1086-92. doi: 10.1288/00005537-199510000-00015.

Abstract

The reported mortality (40%) and neurologic morbidity (25%) rates for carotid rupture remain unacceptably high. This study was conducted to assess the impact of endovascular detachable balloon occlusion and the changing characteristics of carotid rupture in head and neck surgery. Between January 1, 1988, and June 30, 1994, 18 carotid ruptures were identified in 15 patients. Etiologic factors included radical surgery, radiation therapy, wound complications, and recurrent or persistent carcinoma. In 15 of 18 instances of carotid rupture, patients survived without major neurologic sequelae. After the introduction of endovascular techniques in 1991, the 12 patients whose hemorrhage was definitively managed through permanent balloon occlusion survived without significant neurologic sequelae. Endovascular occlusion techniques in the monitored patient may significantly improve the outcome after carotid rupture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / surgery
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Injuries*
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Female
  • Head and Neck Neoplasms / complications
  • Head and Neck Neoplasms / surgery
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / etiology
  • Hemorrhage / mortality
  • Hemorrhage / therapy*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy*
  • Radiography
  • Radiotherapy / adverse effects
  • Retrospective Studies
  • Rupture